Could face loss of already trained workers

Tom Landy is worried about which home-care worker will come next through his door.

The Winnipeg Regional Health Authority is in the final stages of switching home-care workers in Winnipeg to equivalent full-time (EFT) positions from part-time casual. The 37-year-old, who lives with spinal muscular atrophy, has been told there will be a lot of new faces who, at first, will have little knowledge about his care.

Landy, who weighs 43 pounds, requires a home-care worker 21 hours a day, six days a week.

"I know the people I have now are capable of lifting me. They've sent lots of people (in the past) who can't lift me. And I had one person who kept forgetting how to turn the ventilator on," said Landy, who is so frail he must be lifted by his parents, Ed and Brenda, or a worker as he can't tolerate the straps of a Hoyer lift.

'They really need to see the consequences of these changes and reshuffling people like this for no real reason'

Ed built a custom lift out of a car jack into his sofa to raise his son to the level occupational therapists said was needed for a worker to safely lift him.

"Some effort should have been made to give clients stability and stress-free (from worries), but the clients don't seem to be very important here at all," Landy said.

Spinal muscular atrophy is a genetic disease that attacks nerve cells in the spinal cord and causes the degeneration of voluntary muscles used in walking, breathing, swallowing and head and neck control. It is usually terminal.

Landy lost his younger brother, Joe, to the disease nearly 20 years ago. Landy's own life depends on his specific care needs being delivered correctly and safely by a worker with specialized training. He needs a ventilator to assist with his breathing, a suction machine to clear his lungs and a motorized wheelchair for mobility.

When the EFT rollout is complete in his area on April 6, Landy is all but guaranteed he will lose his two daytime home-care workers with whom he has bonded over the past four years.

Home-care staff can request preferred shifts and areas of the city. They can't request clients.

Réal Cloutier, the Winnipeg Regional Health Authority's chief operating officer and VP for long-term and community care, said the move to EFT will improve conditions for home-care workers who can now count on a guaranteed income. The hope is there will be less staff turnover. Workers can request the number of hours per day they want to work and be scheduled to receive those hours.

"People are choosing, based on seniority, what position they want. Then we have to align client care to those positions. You add a further level of complexity because we're also having to shift some of the times care is delivered (depending on staff availability)," Cloutier said in an interview.

There are about 2,500 home-care workers and 14,000 clients affected by the EFT rollout, which is at the end of the WRHA's five-year implementation plan.

"What seems to be a simple request of 'I want to keep my worker' and 'I want to keep the time I'm getting service' becomes almost a mathematical impossibility," Cloutier said. "I know it sounds bureaucratic, but the reality is, we're making a pretty substantive change."

Brenda Landy said she's concerned for her son's comfort and well-being.

"He's got dignity too," she said. "We don't want new people coming and going all the time, taking him to the bathroom. I get frustrated with that. He deserves to feel safe with people he knows and trusts."

Ed Landy said in addition to his son's health and safety, home security is an issue if there are a lot of different people coming in and out of their house.

"I feel like I'm being treated more like a product," Tom Landy said. "They really need to see the consequences of these changes and reshuffling people like this for no real reason. They're going to have to train new people, when I already have really good people who are already trained."

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